Background: Caniopharyngiomas in spite of being benign
tumors they have a high rate of recurrence of which cysts
constitute major component. Ommaya Reservoir System
(ORS) is a simple manoeuvre for percutaneous drainage of
cysts.
Aim of Study: To evaluate the efficacy of using C-arm as
a guiding tool for placement of Ommaya reservoir tube in
predominantly cystic recurrent craniopharyngiomas.
Patients and Methods: This study included 8 patients
with clinically symptomatic and radiologically confirmed
recurrent craniopharyngioma with significant cystic part.
These patients were treated by C-arm guided insertion of
Ommaya reservoir tube. The technique is described in details.
CT brain was obtained in the first post-operative night to
assess the position of the tube. Post-operative clinical and
radiological evaluations were compared to the pre-operative.
Results: This study included 6 males and 2 females,
ranging in age from 5 years to 38 years with mean age of 18.4
years. Headache was the most common presenting complaint,
followed by visual impairment. All surgeries were performed
with C-arm guidance and post-operative CT brain documented
satisfactory position of the tube in 7 cases and only one case
required second look surgery for repositioning of the tube
with the same technique. Significant post-operative improvement
of headache and visual symptoms were encountered in
all cases due to decompression of the optic chiasm by cyst
drainage.
Conclusion: C-arm assisted insertion of Ommaya reservoir
tube is a reliable method that can minimize the errors of free
hand technique and of special value in low facility centers. |
